Mississippi hospitals are fuller than they were four years ago, according to data collected by the federal government between March 2020 and April 2024.
Hospitals with over 250 licensed beds saw a 7.6% increase in average annual occupancy rates, or the percentage of staffed beds filled with patients, from 73.1% in 2020 to 80.7% in 2024.
A shortage of health care workers, which limits the number of beds a hospital is able to open, is one factor that contributes to high occupancy rates.
“Our staffing hasn’t rebounded since COVID,” said Kim Hoover, interim president and CEO of the Mississippi Hospital Association. “… Unfortunately there are some beds that are there but they’re not available because there aren’t staff there.”
The nursing shortage is the primary factor limiting hospital bed availability, she said.
Only 37.2% of registered nurses in Mississippi work in a hospital setting. Hospital registered nurse (RN) position vacancies skyrocketed to 3,038 statewide in 2022, according to a Mississippi Hospital Association survey in which 82% of Mississippi hospitals responded.
Hoover, who is a registered nurse, cited heavy workloads, a desire for regular working hours and higher pay as reasons nurses choose to seek work elsewhere.
She said staffing shortages can lead to burnout and impose restrictions on the support nurses are able to provide to patients. “It’s difficult to be able to spend time with the family and the patient,” she said. “...Sometimes there are opportunities that we just don’t get to take.”
Some hospitals have responded to staffing challenges by offering sign-on bonuses, more flexible hours and pay incentives. Alicia Carpenter, director of marketing for Merit Health Central, said the hospital has worked to ensure that its pay is competitive and has launched a loan repayment program for employees.
In the past year, “nursing retention has substantially and measurably increased,” she said.
Nationwide, hospital turnover rates have declined 2% from 2022 to 2023, according to a report from NSI Nursing Solutions Inc., a national nurse recruiting firm.
Several large hospitals saw declines in the average number of staffed beds by over 30% during that period, including Delta Health System - The Medical Center in Greenville, Merit Health Central in Jackson and Singing River Health System in Pascagoula.
North Mississippi Medical Center, the second largest hospital in the state with 640 licensed beds, averaged 387 staffed beds in 2020. From 2021 to 2023, the hospital’s average staffed beds dropped below 300 – less than half of the hospital’s licensed bed capacity.
In the first four months of 2024, the Tupelo hospital’s capacity rebounded to an average of 345 beds.
North Mississippi Medical Center declined to comment for this story. Delta Health System - The Medical Center did not respond to a request for comment.
The U.S. Department of Health and Human Services stopped requiring hospitals to report capacity and occupancy data on May 3, ending provisions intended to track COVID-19 pandemic data. Hospitals can opt to continue voluntary reporting.
Occupancy rates may also be impacted by hospital closures or reduced patient services and an aging population.
Forty-five rural hospitals in the state – or 62% – have already experienced losses in patient services, according to an April 2024 study from the Center for Healthcare Quality and Payment Reform. More than half of Mississippi’s rural hospitals are at risk of closing, according to the same report.
When rural hospitals close or reduce services, transfer volumes balloon at large urban hospitals, said Dan Woods, St. Dominic’s Hospital senior director of emergency services and throughput.
St. Dominic’s averages 4,000 to 5,000 transfers from other hospitals annually.
“When one goes down, we all kind of carry the burden,” he said.
St. Dominic’s often accepts stroke patients transferred from other hospitals to its Comprehensive Stroke Center. Wood said the center sees about 175 patients presenting signs of a stroke each month.
“That’s a huge volume of patients that are coming in,” Wood said. “And we’re going to see that number grow as rural hospitals continue to struggle.”
Wood said that Mississippi’s aging population also contributes to higher hospital occupancy rates. Geriatric patients are more likely to have more comorbidities like hypertension, diabetes or obesity.
Mississippi’s older population is increasing. Between 2010 and 2021, the state saw a 29.3% increase in adults over 65.
“The nursing shortage is not going away and will continue to grow with a higher aging population demand,” said Ashley Butsch, public relations manager for Singing River Medical Center.
“I expect to see occupancy rates incline for everybody,” Wood said.
Hoover said that she is hopeful that collaboration between hospitals could be the key to mitigating the staffing and occupancy challenges Mississippi hospitals face.
The organization is working on developing a health information exchange platform to transmit real time hospital data to facilities statewide. Hoover said she hopes the program, called IntelliTrue, will roll out before next spring.
Currently, hospitals share occupancy data with the Mississippi Department of Health once each day, but that information can quickly become out of date.
Because there is no statewide, continuously updated data hub, hospital staff must call other institutions to facilitate a patient transfer.
“Sometimes they’ll call five, six, seven, eight, nine, 10 people and … they say, ‘well, we don’t have a bed,’” said Hoover.
The new program will allow hospitals to share real time capacity information.
Hoover acknowledged that while the system will not help with staffing shortages, it will allow patients to be more seamlessly transferred to facilities with the capacity to treat them.
“It’s better for us to care for our folks here in the state of Mississippi,” Hoover said. “So the goal really is, to be able to keep all of our patients in Mississippi so they can stay in their community as much as possible.”
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